Search

Background Studies in India have reported a high prevalence of nutritional anemia among children and adolescent girls. Nutritional anemia is associated with impaired mental, physical, and cognitive performance in children and is a significant risk factor for maternal mortality. Objective To evaluate the effect of a community-led initiative for control of nutritional anemia among children 6 to 35 months of age and unmarried rural adolescent girls 12 to 19 years of age. Methods This Participatory Action Research was done in 23 villages of the Primary Health Centre, Anji, in Wardha District of Maharashtra. In February and March 2008, needs assessment was undertaken by interviewing the mothers of 261 children and 260 adolescent girls. Hemoglobin levels of adolescent girls and children were measured with the use of the hemoglobin color scale. The girls were given weekly iron—folic acid tablets, and the children were given daily liquid iron prophylaxis for 100 days in a year through community participation. The adolescent girls and the mothers of the children and adolescent girls were also given nutritional education on the benefits and side effects of iron supplementation. In June and July 2008, follow-up assessment was performed by survey and force field analysis. Results There was a significant reduction in the prevalence of nutritional anemia from 73.8% to 54.6% among the adolescent girls and from 78.2% to 64.2% among the children. There was improvement in awareness of iron-rich food items among the adolescent girls and the mothers of the children. The benefits to girls, such as increase in appetite and reduction in scanty menses, tiredness, and weakness, acted as positive factors leading to better compliance with weekly iron supplementation. The benefits to children perceived by the mothers, such as increase in appetite, weight gain, reduction in irritability, and reduction in mud-eating behavior, acted as a dominant positive force and generated demand for iron syrup. Conclusions The community-led initiative for once-weekly iron supplementation for adolescent girls and iron prophylaxis for children, in addition to nutritional education, improved the hemoglobin status of children 6 to 35 months of age and unmarried rural adolescent girls 12 to 19 years of age.

Background Iron supplementation through prenatal care remains the most widespread strategy to control anemia during pregnancy, but its effectiveness is only partial, showing the need to address other approaches. Objective This study was conducted to measure the impact of a positive deviance approach to improve an iron-supplementation program among pregnant women in a rural Senegalese area. Methods A positive deviance approach (PD Micah) was compared with an ongoing integrated nutrition and health program intervention (Micah) in a rural Senegalese area. A pre-post evaluation was conducted using independent cross-sectional samples with a total of 371 pregnant women. A sociodemographic questionnaire was administered, and biologic and anthropometric measurements were performed. Results After 9 months of activities, the mean hemoglobin level rose from 93.9 to 100.7 g/L in the PD Micah group. Distribution of iron supplements through community volunteers and implementation of healthy pregnancy promotion sessions on a monthly basis improved the accessibility to 23.3% in the PD Micah group. No significant change was observed in the Micah group. Logistic regression analysis showed a significantly reduced risk of anemia in the PD Micah area (adjusted odds ratio, 0.25; 95% confidence interval, 0.12 to 0.53). Conclusions This intervention shows that a community-based strategy, such as the positive deviance approach, can contribute to improving the effectiveness of iron supplementation during pregnancy.

Vitamin A is an essential nutrient, for which there is a slightly increased requirement during the third trimester of pregnancy, with even greater requirements for lactating women. Serum retinol levels decline during pregnancy, especially during the third trimester, followed by a rapid increase postpartum. Hemodilution and inadequate nutritional status contribute to this pattern. Night-blindness is more common in the third trimester of pregnancy, and night-blind pregnant women have lower mean serum retinol concentrations. Increased morbidity is associated with night-blindness in women, especially during pregnancy. Vitamin A supplementation during pregnancy in deficient populations reduces night-blindness, low serum retinol levels, and nutritional anemia during pregnancy and substantially reduces maternal postpartum infections. A substantial reduction in maternal mortality has been observed in malnourished vitamin A–deficient women following vitamin A or β-carotene supplementation. Infant cord blood retinol and birthweight appear to be resistant to maternal supplementation with vitamin A during pregnancy. No studies have reported an impact of maternal vitamin A supplementation on neonatal morbidity or mortality.

The iron status at six months of age for a total of 66 three-month-old, full-term, normal-birthweight Jordanian infants who were exclusively breastfed for four, five, or six months postpartum is reported here. Three groups of infants were identified who were exclusively breastfed for four months (n = 14), five months (n = 15), and six months (n = 37). Iron status was evaluated by haemoglobin, plasma ferritin, and mean corpuscular volume. the prevalences of nutritional anaemia (haemoglobin < 10.5 g/dl), iron-deficiency anaemia (haemoglobin < 10.5 g/dl, mean corpuscular volume < 70 fl, and plasma ferritin < 12 ng/ml), and depletion of iron stores (plasma ferritin < 12 ng/ml) were significantly higher (p < .05) in infants exclusively breastfed for four months than in the other two groups. Significant differences were not observed between the latter two groups in the prevalence of any of these indices. Under the conditions of this study, which was carried out in a community of low to medium socio-economic status where iron-fortified weaning foods were not used, the data strongly suggest that exclusive breastfeeding for five or six months is protective against the development of nutritional anaemia or iron-deficiency anaemia at six months of age. the weaning foods used in this community have low iron content and bioavailability.

A study of dietary intakes of calories, protein, fat, carbohydrate and iron, along with determinations of hemogram, serum iron, iron binding capacity, transferrin, transferrin saturation and plasma proteins, was done on 26 Day Care children and 15 non-Day Care controls, aged 7 to 32 months, all registered in a Children and Youth health care program. Significant differences favoring the Day Care children were limited to HGB and HCT in the older children, and HGB, HCT, MCV, MCH, transferrin, and iron binding capacity in the younger children. Daily intakes calculated from nutritional history obtained from the parent or observed in the Day Care unit showed average iron intake low in all children. As a result of these findings, it is suggested that children under two years of age be afforded preference over older children when spaces are available in Day Care Centers, and that the dietary intakes of these children be examined carefully to ensure that they are receiving optimal nutrients.

The effect of radiant energy upon the metabolism of small doses of Fe in the nutritional anemia of the rat seems to have been little studied. Foster1 produced anemia in rats by milk feeding and observed the effect of radiant energy in preventing and curing this type of anemia. There was a slight but definite effect in increasing the hemoglobin and the number, size and saturation of the red cells.We have made the following studies upon the effect of radiant energy upon both the prevention and cure of nutritional anemia in the rat.Preventive Studies. Young rats at weaning were fed upon whole milk. Daily doses of pure Fe from 0.05 to 0.30 mg. were given, with and without 3/4 hour ultraviolet irradiation of the rat daily, with the General Electric Sunlight Mazda Lamp, Type S-I, at a distance of 4 feet. This lamp has recently been described by Carter.2 Weekly estimations of hemoglobin and red cell counts were made by the technique described by Beard and Myers.8With milk alone, milk plus irradiation, irradiated...

Our knowledge of some of the many aspects of the problem of anemia has been enlarged recently by studies on the milk anemia of the rat. Thus from the work of the Wisconsin investigators the importance of Cu in Hb regeneration is now generally appreciated. Cu therapy, however, does not present any particular difficulty, while Fe deficiencies and Fe therapy still remain important problems in the clinic. For such investigations milk anemia is a convenient experimental approach. Although much work has been done there is still some uncertainty regarding the response of anemic rats to small doses of Fe.1, 2 Certain investigators3, 4 have reported that glutamic acid supplements Fe in nutritional anemia, but this has not been confirmed by others.5The following experiments were carried out with about 300 rats in order to clarify some of the discrepancies in regard to the effect of Fe in anemia and to determine whether glutamic acid could be employed as an effective vehicle for the administration of minerals in sec...

While our studies on milk anemia1, 2 were in progress, evidence appeared in the literature3, 4 which indicated that cobalt stimulated blood regeneration in nutritional anemia, Therefore, experiment...

Pure milk fed to young rats produces severe anemia which finally results in death in the majority of cases. In our studies of the pathological changes which take place during the course of nutritional anemia in the albino rat, the findings in the liver and spleen seem to have considerable value in the differential diagnosis of this type of anemia as contrasted with the infectious type caused by Bartonella muris. All our examined animals showed a severe degree of anemia with an erythrocyte count of less than 3 million per c.mm. and a Hb content of less than 4 gm. per 100 cc. Most of the animals died spontaneously, while 5 were killed during the course of the disease. The spontaneous death of the anemic animals was consistently preceded by a rapid loss of weight during the last days of life. The liver and spleen were weighed and fixed with the other organs in Zenker, alcohol and formalin. Slides for microscopic study were stained with hematoxylin-eosin, van Gieson, Mallory, Bielschovsky, Sudan III and Turnb...

SummaryThe amount of coenzymatically active Vit. B6 was determined in plasma and leukocytes in patients with various diseases. Values for plasma and leukocytes varied widely in all groups examined. A statistically significant decrease of plasma B6 was found only in patients with nutritional anemia and various forms of leukemia. However, the amount of pyridoxal phosphate was very low in individual patients with various other diseases. This may indicate a decreased intake of vitamin in some hospitalized patients or an increased need for it. B6 values in leukocytes were consistently decreased in patients with various forms of leukemia. In contrast, cells from normal bone marrow and from tonsils showed significantly higher amounts of pyridoxal phosphate. The findings are discussed with reference to a specific disturbance in B6 metabolism in some neoplastic conditions.

Following Hart, Steenbock1 et al. on the influence of minute amounts of copper in improving the hemoglobin in rats with nutritional anemia it seemed desirable to determine whether or not this same thing could be obtained in the anemia of the rat induced by repeated bleedings.We have compared two series of rats, (1) a group made anemic by long continued milk diet; (2) a group of normal animals made anemic by repeated bleedings. In both groups the animals were of the same age and weight, and treated exactly alike in every other particular.Group I. Nutritional Anemia Group. These rats were kept on a diet of milk until they showed a definite anemia, and then divided into 3 sub-groups. The first sub-group was kept on milk only. The second sub-group was kept on milk with the addition of iron and copper. The third sub-group was kept on milk with iron only. The amount of iron used was 3 mg. per rat per day given in the form of ferric ammonium citrate. The amount of copper used was one-tenth milligram per rat per ...

This work is the outgrowth of the studies made by the authors on the relation of iron and copper to nutritional anemia and hemoglobin synthesis. It is well known that cow's milk is inadequate for the normal maintenance of the rat. Additions of copper and iron salts to an exclusive milk diet protect animals from nutritional anemia and produce an apparent well being in the animals of the first generation from the standpoint of hemoglobin formation, growth, and reproduction. Underhill, Orten, Mugrage, and Lewis1 have observed no abnormalities in the organs of rats fed milk, copper, and iron for periods of more than a year. Waddell2 reported sterility in males of the first generation receiving a milk, copper, and iron diet. The sterility was marked by a progressive testicular degeneration together with an absence of motile sperm in the seminal fluid. Ferric chloride, when added to the ration, was found to produce symptoms of sterility as early as 10 weeks after administration. Keil, Keil, and Nelson3 found th...

During a continuation of our studies on nutritional anemia, a polycythemia was observed in rats receiving a certain mixture of metals with Cu as a supplement to a milk-Fe diet, whereas the same mixture of metals without Cu failed to produce this condition. The data are reported together with those from a study of the metals or combination of metals responsible for the polycythemia.Male albino rats, 26 days old, were placed in glass cages and fed whole milk for 4 days. A mixture of Mn, Co, Ni, Zn, Cu, and Fe salts was then added as a supplement to the milk diet 6 days a week. All metals were fed as the same preparations, and at the lower levels, used in our previous work.1Weekly hemoglobin determinations showed normal values until the animals were 7 to 9 weeks of age, when a definite increase in hemoglobin occurred. The rats presented an extremely ruddy appearance, and their eyes, ears, and paws became deep red. When it was evident that this was not a transitory condition, hematological studies were made o...

The recent recognition of a specific organic food factor12 necessary for the maintenance of the black fur of black or piebald rats has raised the question as to whether the phenomenon of graying noted by older workers3456 particularly in rats on an exclusive milk diet is due to this cause or is due to a specific mineral deficiency. Jukes and Richardson7 have pointed out that milk is not a good source of filtrate fraction vitamins.The black fur of young piebald rats fed an exclusive diet of either powdered whole milk or of fresh certified milk rapidly and uniformly became gray. Addition of a supplement of 0.25 mg of iron, 0.05 mg of copper and 0.05 mg of manganese cured the grayness if it had developed or prevented any change in the color of the fur of rats which were fed milk with the above mineral supplements from the time of weaning. Attempts to ascertain which of the 3 metals is responsible have not at present yielded entirely conclusive results.Rats developing a nutritional anemia show a marked diminu...

Waddell, Steenbock, Elvehjem, and Hart1 showed that rats fed milk exclusively developed nutritional anemia and that the ingestion of pure iron salts failed to cure it. However, normal regeneration of hemoglobin was obtained with small additions of copper sulphate along with the iron salt. These results have been confirmed by Keil and Nelson.2 Myers and Beard3 found that higher doses of zinc and magnesium retarded blood regeneration. If this is the case, anemia should develop more rapidly on milk and FeCl3 if these elements are included. The slope of the curves obtained with and without zinc or magnesium demonstrate that anemia resulted as readily with or without these elements.Prior to this work on hemoglobin regeneration, Daniels and Hutton4 demonstrated that rats failed to reproduce on milk and iron, but reproduction was a success when a mineral mixture of NaI, NaF, KAl (SO4)2, MnSO4, and Na2SiO3 was added. They concluded that all of these salts were necessary in the milk for reproduction. The work of H...

The experiments here described were undertaken to ascertain whether different functional levels of the thyroid gland as induced by the administration of iodine play any part in the development or severity of the anemia produced by milk feeding.Kunde, Green and Buno1 have shown that hypothyroidism is accompanied by mild anemia and Drennan, Malcolm and Cox2 produced thyroid hyperplasia in rats on a diet of white bread and fresh milk. This hyperplasia was easily corrected by the addition of a small amount of iodine. The iodine content of milk is low but varies considerably in different samples,3 thus suggesting that lack of iodine and consequent thyroid hypo function may complicate the nutritional anemia in some instances.Male rats, chosen from litters made anemic by the method of Elvehjem and Kemmerer,4 were weaned and continued on whole milk powder (Klim) until 6 weeks of age. They were then placed in individual screen bottom cages and for the succeeding 8 weeks were fed the various supplements indicated i...

The investigation made for the purpose of determining the influence on the hemapoietic system of various substances commonly used in infant feeding included a study of both rats and infants.In the work with rats, substances recommended for infant feeding: carbohydrate milk modifiers, orange juice, tomato juice, autolyzed yeast, liver, egg yolk, Vitamin B containing extracts, and various iron and copper additions, were tested. These were fed in conjunction with milk in proportions comparable to those used in infant feeding. Unmodified milk diets including both boiled and pasteurized were included, also, for comparison. Fifty-seven animals were fed, 2 to 3 on each diet, for 6 to 18 weeks. Hemoglobin determinations (Newcomer method) were made at the beginning of experimental diet and after 7 weeks of the diet. Records of food ingestion and body weights were kept to see what relation these have to hemoglobin formation.The results of the investigation indicated that carbohydrate milk modifiers used in infant f...

Young rats were made anemic by feeding whole milk for a period of 6 weeks after weaning. When the erythrocyte count was about 3-4 million per cu. mm., and the Hb content 4-6 gm. per 100 cc., additions of Fe, Fe + Cu, Fe + Ni, Fe + Co, and Fe + Ge, Fe + Na2GeO3 were made. Erythrocyte counts and Hb estimations were made weekly on a few drops of blood obtained by clipping the end of the tail. A Levy counting chamber with double Neubauer ruling was used. Hb determinations were made by the acid hematin method, color comparison being made with a calibrated Newcomber disc. The results are summarized in the table.When 0.5 mg. Fe was given daily to anemic rats recovery of both erythrocytes and Hb was complete in 4.3 and 6 weeks; with 1 mg. the time for recovery was 3.5 and 4.8 weeks; and with 1.5 mg. it was 3.5 and 3.7 weeks, respectively. Since this iron solution was prepared from standard iron wire using hydrochloric and nitric acids, it would hardly seem that the effect of iron salts, as FeCl3, in blood regener...

In studying the effect of evaporated milk upon the development of nutritional anemia in the albino rat, it was observed that the erythrocytes were maintained at a normal level over a period of 8 weeks in spite of the fact that the hemoglobin fell slowly. This was in sharp contrast to the findings on rats which were fed raw milk, where both the erythrocyte count and the hemoglobin showed a marked decrease in 7 1/2 weeks.In the majority of evaporated milk plants the milk comes in close contact with copper during the manufacturing process. Since according to Rice and Miscall1 copper is dissolved by milk under such conditions, an investigation has been undertaken to determine if this metal is the causative factor in the maintenance of the red cell count when evaporated milk is fed.Albino rats, 21 days of age, were fed raw milk supplemented by 0.025 mg. of copper (as CuSO4) daily over a period of 8 weeks. Erythrocyte counts and hemoglobin determinations were made at the beginning of the experiment and at inter...

Since work from this laboratory1 has indicated that copper is not the only inorganic element which can supplement iron to bring about hemoglobin regeneration in the nutritional anemia of the rat, the present study was undertaken to compare the influence of copper and other elements on the iron content of the liver. The experimental procedure was very similar to that employed by Elvehjem and Sherman.2 The tissue iron content was determined by the method described by Hanzal.3The present report deals only with the influence of copper. The accompanying table shows the changes in the iron content of the various rat livers.As can be seen when iron is administered to the anemic animal for 14 days there is an increase in the iron content of the liver as well as an increase in the blood hemoglobin and erythrocytes. With discontinuing the iron at the end of 14 days and giving milk only the liver iron decreases as does the blood hemoglobin and erythrocytes. When copper is given at the end of 14 days, and no iron, th...

During an investigation pertaining to the influence of certain foods on anemia in rats, it was observed that the hearts of those having low hemoglobin values were considerably larger than the hearts of normal animals. Thereupon the weights of the hearts of the experimental animals, computed on the percentage basis, were compared with those of normal animals as given by Donaldson. Successive biweekly hemoglobin determinations were made throughout the period of study, the last being taken just before the animals were killed. The results indicate that there is a close correlation between the size of the heart and the degree of anemia. The heart weights of animals with high hemoglobin values—from 11 gm. to 14 gm. per 100 cc. of blood (Newcomer method) are comparable to those given by Donaldson. When the hemoglobin values fell to 10 gm. the hearts were slightly hypertrophied; this became more marked as the degree of anemia increased. At the very low hemoglobin levels, from 2 gm. to 3 gm. per 100 cc., the heart...

Cardiac hypertrophy resulting from nutritional anemia reported by Forman and Daniels1 was based on moist heart weights. There was nothing to indicate whether the enlargement was a true hypertrophy—an increase in muscle fiber, or was caused by an imbibition of water. In the present study both moist and dry heart weights of anemic rats at different hemoglobin levels, were compared on the basis of sex, age, body weight, and body length with those of normal animals of the same sex, age, length, and weight. In an attempt to determine the fate of these hypertrophied hearts, other anemic animals were fed anemia correcting diets. When the haemoglobin and red cell count were again within the normal range, their hearts were compared with those of normal individuals.The findings indicate that nutritional anemia produces a true cardiac hypertrophy, the result of increased muscle fiber. The dried heart weights were found to be distinctly heavier, whether compared on the basis of age, weight, or length, the degree of e...